影像学在非酒精性脂肪性肝病临床研究及实践中的地位

Role of imaging techniques in clinical research and practice on nonalcoholic fatty liver disease

腹部超声(US)、计算机断层扫描(CT)和磁共振影像(MRI)均被用于非酒精性脂肪性肝病(NAFLD)的临床诊断和研究中。阐述了US、CT、MRI评价NAFLD的优势与局限性。与传统影像学检查相比,多参数定量MRI技术能够客观全面地评价NAFLD。脂肪质子密度(PDFF)被认为是脂肪肝诊断金标准并被应用于临床研究中。PDFF的实用性、可靠性、可转化性在成人及儿童的独立临床研究中通过多个MR扫描系统及应用软件被反复证实。磁共振弹性成像能够评价肝纤维化程度,且不受肝脂肪变性的影响。NAFLD肝脂肪沉积及纤维化均可在MRI检查中一站式测定,并在一定程度上成为替代肝穿刺的诊断方法。

Abdominal ultrasound（ US）,computed tomography（ CT）,and magnetic resonance imaging（ MRI） have been used in the clinical diagnosis and management of nonalcoholic fatty liver disease（ NAFLD）. This article elaborates on the advantages and limitations of US,CT,and MRI in the evaluation of NAFLD. Compared with conventional imaging examinations,multi-parametric quantitative MRI allows for comprehensive and objective evaluation of NAFLD. Proton density fat fraction（ PDFF） is considered the gold standard for the diagnosis of fatty liver disease and has been applied in clinical research. Independent clinical studies in adults and children have confirmed the practicability,reliability,and transformative quality of PDFF using various MRI scanning systems and software. Magnetic resonance elastography is used to evaluate the degree of liver fibrosis and is not affected by hepatic steatosis. In patients with NAFLD,MRI can measure hepatic fat deposition and fibrosis in a single examination and,to a certain degree,it can replace liver biopsy.